Alexandre Larouche1, Andreas Becker2, Jonas Schiffmann3, Florian Roghmann4, Giorgio Gandaglia5, Nawar Hanna1, Zhe Tian6, Paul Perrotte7, Thorsten Schlomm8, Markus Graefen9, Sascha Ahyai10, Quoc-Dien Trinh11, Pierre I Karakiewicz1, Maxine Sun6. 1. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Department of Urology, University of Montreal Health Centre, Montreal, QC; 2. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; ; Department of Urology, University-Hospital Hamburg-Eppendorf, Hamburg, Germany; 3. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 4. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Department of Urology, Ruhr University Bochum, Marienhospital, Herne, Germany; 5. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; ; Department of Urology, Vita-Salute, San Raffaele University, Milan, Italy; 6. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Centre, Montreal, QC; 7. Department of Urology, University of Montreal Health Centre, Montreal, QC; 8. Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; ; Department of Urology, Section for Translational Prostate Cancer Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 9. Martini-Clinic, Prostate Cancer Center, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; 10. Department of Urology, University-Hospital Hamburg-Eppendorf, Hamburg, Germany; 11. Department of Surgery, Division of Urology, Brigham and Women's Hospital/Dana-Farber Cancer Institut, Harvard Medical School, Boston, MA.
Abstract
INTRODUCTION: We compare the complication rates and length of stay (LOS) of laser transurethral resection of the prostate (L-TURP) versus electrocautery transurethral resection of the prostate (E-TURP) in a population-based cohort. L-TURP has shown enhanced intraoperative safety and equivalent efficacy relative to E-TURP in several high volume centres. METHODS: Relying on the Florida Datafile as part of the Healthcare Cost and Utilization Project State Inpatient Databases (SID) between 2006 and 2008, we identified 8066 men with benign prostate hyperplasia who underwent L-TURP or E-TURP. Chi-square and Mann-Whitney tests were used to compare baseline characteristics. A multivariable linear regression model was used to analyze the effect of L-TURP versus E-TURP on complication rates and LOS. RESULTS: Overall complication rates did not differ significantly for L-TURP compared to E-TURP in univariable (8.8 vs. 7.4%, p = 0.1) and multivariable analyses (odds ratio [OR]: 1.06, confidence interval [CI]: 0.85-1.32, p = 0.6). Individuals undergoing E-TURP were less likely to experience a LOS in excess of 1 day (46.2 vs. 59.7%, p < 0.001). A lower risk to experience a LOS in excess of 1 day was confirmed for patients undergoing L-TURP after a multivariable linear regression model (OR: 0.37, CI: 0.23-0.58, p < 0.001), but not for a LOS in excess of 2 days (OR: 0.96, CI: 0.83-1.10, p = 0.2). CONCLUSIONS: Patient characteristics and perioperative safety were similar for L-TURP and E-TURP patients. However, LOS patterns demonstrated a modest benefit for L-TURP compared to E-TURP patients.
INTRODUCTION: We compare the complication rates and length of stay (LOS) of laser transurethral resection of the prostate (L-TURP) versus electrocautery transurethral resection of the prostate (E-TURP) in a population-based cohort. L-TURP has shown enhanced intraoperative safety and equivalent efficacy relative to E-TURP in several high volume centres. METHODS: Relying on the Florida Datafile as part of the Healthcare Cost and Utilization Project State Inpatient Databases (SID) between 2006 and 2008, we identified 8066 men with benign prostate hyperplasia who underwent L-TURP or E-TURP. Chi-square and Mann-Whitney tests were used to compare baseline characteristics. A multivariable linear regression model was used to analyze the effect of L-TURP versus E-TURP on complication rates and LOS. RESULTS: Overall complication rates did not differ significantly for L-TURP compared to E-TURP in univariable (8.8 vs. 7.4%, p = 0.1) and multivariable analyses (odds ratio [OR]: 1.06, confidence interval [CI]: 0.85-1.32, p = 0.6). Individuals undergoing E-TURP were less likely to experience a LOS in excess of 1 day (46.2 vs. 59.7%, p < 0.001). A lower risk to experience a LOS in excess of 1 day was confirmed for patients undergoing L-TURP after a multivariable linear regression model (OR: 0.37, CI: 0.23-0.58, p < 0.001), but not for a LOS in excess of 2 days (OR: 0.96, CI: 0.83-1.10, p = 0.2). CONCLUSIONS:Patient characteristics and perioperative safety were similar for L-TURP and E-TURP patients. However, LOS patterns demonstrated a modest benefit for L-TURP compared to E-TURP patients.
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